What We Mean by Eliminating Mental Health Stigma

2014-June 18
by Don Matteson, Chief Program Officer

As part of our strategic planning process a couple of years ago, our Trustees and staff established goals for each of our four issue areas. These goals were intended to reflect the, "desired end state" for the populations we serve in the communities we fund.

When we got to the mental health category, we led off with a biggie: "Stigma related to mental illness is eliminated." Do we think that we're going to eliminate mental health stigma? Not really (and certainly not on our own), but why not swing for the fences? It's a super-ambitious goal, and any movement in that direction will be important for people who live their lives at the fringe because their community members don't want them any closer.

An interesting observation I've made in the couple of years since we changed our grant guidelines to reflect this goal is that eliminating stigma seems to mean different things to different people. In some cases, we get requests suggesting that a program or project will work towards eliminating mental health stigma by changing attitudes, beliefs, and values within a group of people. Other times, the idea is that a project or program will reduce stigma by placing mental health services where the community can't see who's accessing them (e.g., within primary care or in multi-service community organizations).

It's the latter suggestion that concerns me. By locating mental health services so that the community can't tell who's accessing them, we're not reducing or eliminating stigma. As far as I can tell, we're perpetuating it. When we tell people that it's okay to seek treatment for mental illness or counseling to enhance mental health, then mask the fact that they're seeking these services, we're not actually telling people that it's okay. We're perpetuating the idea that seeking such services is something the be ashamed of. It's not okay, so you should make sure nobody knows that you need help.

This isn't to say that co-locating mental health services is a bad idea. Mental health stigma still represents a significant obstacle to be overcome for people who need treatment. Anything we can do to reduce the obstacles to treatment is worthwhile, but doesn't necessarily get us where we want to go in the long run with respect to stigma.

All I'm saying is that we should just make sure that we're clear about what we're trying to accomplish. Co-locating services reduces barriers to access, but doesn't reduce stigma. Eliminating stigma will require changing attitudes, beliefs, and values.